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IntroductionDespite extensive evidence of its benefits and recommendation by guidelines, cardiac rehabilitation (CR) remains highly underused with only 20%–50% of eligible patients participating. We aim to implement and evaluate the Country Heart Attack Prevention (CHAP) model of care to improve CR attendance and completion for rural and remote participants.Methods and analysisCHAP will apply the model for large-scale knowledge translation to develop and implement a model of care to CR in rural Australia. Partnering with patients, clinicians and health service managers, we will codevelop new approaches and refine/expand existing ones to address known barriers to CR attendance. CHAP will codesign a web-based CR programme with patients expanding their choices to CR attendance. To increase referral rates, CHAP will promote endorsement of CR among clinicians and develop an electronic system that automatises referrals of in-hospital eligible patients to CR. A business model that includes reimbursement of CR delivered in primary care by Medicare will enable sustainable access to CR. To promote CR quality improvement, professional development interventions and an accreditation programme of CR services and programmes will be developed. To evaluate 12-month CR attendance/completion (primary outcome), clinical and cost-effectiveness (secondary outcomes) between patients exposed (n=1223) and not exposed (n=3669) to CHAP, we will apply a multidesign approach that encompasses a prospective cohort study, a pre-post study and a comprehensive economic evaluation.Ethics and disseminationThis study was approved by the Southern Adelaide Clinical Human Research Ethics Committee (HREC/20/SAC/78) and by the Department for Health and Wellbeing Human Research Ethics Committee (2021/HRE00270), which approved a waiver o

The Bolivian Andes have experienced sustained and widespread glacier mass loss in recent decades. Glacier recession has been accompanied by the development of proglacial lakes, which pose a glacial lake outburst flood (GLOF) risk to downstream communities and infrastructure. Previous research has identified three potentially dangerous glacial lakes in the Bolivian Andes, but no attempt has yet been made to model GLOF inundation downstream from these lakes. We generated 2-m resolution DEMs from stereo and tri-stereo SPOT 6/7 satellite images to drive a hydrodynamic model of GLOF flow (HEC-RAS 5.0.3). The model was tested against field observations of a 2009 GLOF from Keara, in the Cordillera Apolobamba, and was shown to reproduce realistic flood depths and inundation. The model was then used to model GLOFs from Pelechuco lake (Cordillera Apolobamba) and Laguna Arkhata and Laguna Glaciar (Cordillera Real). In total, six villages could be affected by GLOFs if all three lakes burst. For sensitivity analysis, we ran the model for three scenarios (pessimistic, intermediate, optimistic), which give a range of ~ 1100 to ~ 2200 people affected by flooding; between ~ 800 and ~ 2100 people could be exposed to floods with a flow depth ≥ 2 m, which could be life threatening and cause a significant damage to infrastructure. We suggest that Laguna Arkhata and Pelechuco lake represent the greatest risk due to the higher numbers of people who live in the potential flow paths, and hence, these two glacial lakes should be a priority for risk managers.

The human aspects of the community pharmacy work system are vulnerable to medication-related errors. Established models of human error can identify actual or potential hazards, and are important in our understanding the interaction between human and system factors that influence performance. The software, hardware, environment and liveware (SHELL) model, a traditional human factors framework, is used in this article to classify potential sources of error in community pharmacies. A thorough review of the literature identified 50 risk factors which were categorised according to the dimensions of the SHELL model, which focuses on the system in which the pharmacist works, rather than individual performance. This model uses a systematic approach to examine mismatches at the interface between the human and the components of the system that are potential sources of error. The application of this model to hazard identification and error reduction in community pharmacy is explored.

The durability of tuffisitic kimberlite breccia (TKB), which forms the larger part of the ore reserve at the Premier mine, South Africa, is reviewed. Deuteric alteration of primary minerals in the kimberlite results in the formation of montmorillonite, probably the worst of the swelling clays. The introduction of water, either naturally or as a result of mining, can lead to large volume changes exerting considerable pressure on surrounding rock and support. At Premier mine, drilling for tunnel advance, ring drilling and support are carried out in a dry environment, resin capsules are used to install rock bolts, cementitious grouts are mixed with latex rather than water and tunnels are sealed as soon as possible after excavation. Sealant is essential if concrete or shotcrete is used as inter-bolt support., The durability of tuffisitic kimberlite breccia (TKB), which forms the larger part of the ore reserve at the Premier mine, South Africa, is reviewed. Deuteric alteration of primary minerals in the kimberlite results in the formation of montmorillonite, probably the worst of the swelling clays. The introduction of water, either naturally or as a result of mining, can lead to large volume changes exerting considerable pressure on surrounding rock and support. At Premier mine, drilling for tunnel advance, ring drilling and support are carried out in a dry environment, resin capsules are used to install rock bolts, cementitious grouts are mixed with latex rather than water and tunnels are sealed as soon as possible after excavation. Sealant is essential if concrete or shotcrete is used as inter-bolt support.

All cave mining at Premier mine is below a gabbro sill cutting the kimberlite, so failure to exercise good draw control causes problems in the recovery plant from the gabbro. The distinctive gabbro fragments also act as a useful marker for recognising material from 100 m above the drawpoint. The draw control system involves collection of data on amount drawn and loaded per LHD and tipped per pass gathered by the vehicle monitoring and control system and recorded by drivers. Draw control staff monitor drawpoints on a shift basis and record the occurrence, type and height of hangups. Information on drawpoint support, waste and availability is also recorded. The resulting database can produce analyses of the overall pattern of draw control, frequency of occurrence of hangups, secondary blasting efficiencies, and drawpoint and LHD productivity. Results show that ore migrates towards groups of drawpoints that are heavily drawn, with some more than 100% drawn before the gabbro arrives. This indicates that a good mixing algorithm is essential for good draw control. The system has been used in achieving better control and planning of future caves with optimum drawpoint spacing. Further efforts will centre on improving the data-gathering integrity of the vehicle monitoring and control system, and a linear programme that will optimise draw control and productivity., All cave mining at Premier mine is below a gabbro sill cutting the kimberlite, so failure to exercise good draw control causes problems in the recovery plant from the gabbro. The distinctive gabbro fragments also act as a useful marker for recognising material from 100 m above the drawpoint. The draw control system involves collection of data on amount drawn and loaded per LHD and tipped per pass gathered by the vehicle monitoring and control system and recorded by drivers. Draw control staff monitor drawpoints on a shift basis and record the occurrence, type and height of hangups. Information on drawpoint support, waste and availability is also recorded. The resulting database can produce analyses of the overall pattern of draw control, frequency of occurrence of hangups, secondary blasting efficiencies, and drawpoint and LHD productivity. Results show that ore migrates towards groups of drawpoints that are heavily drawn, with some more than 100% drawn before the gabbro arrives. This indicates that a good mixing algorithm is essential for good draw control. The system has been used in achieving better control and planning of future caves with optimum drawpoint spacing. Further efforts will centre on improving the data-gathering integrity of the vehicle monitoring and control system, and a linear programme that will optimise draw control and productivity.

Extensive rock-mass and support damage occurs in the extraction level at Premier Diamond mine, South Africa, as undercutting takes place: if abutment stress levels exceed 20% of the rock mass strength, movement along existing joints and minor shear failure and cracking in rigid concrete linings takes place; if induced stresses exceed 50% of the rock-mass strength, extensive failure of the rock in shear takes place along with destruction of shotcrete linings and concrete footwalls. Stress levels and consequent damage have been found, by monitoring, to be a function of: the extraction ratio on the undercut and extraction level prior to undercutting; the shape of the undercut face; the rate of undercut advance; and the distance of leads and lags between adjacent tunnels on the undercut level. Rigid shotcrete linings and concreted footwalls are only completed after the undercut has passed overhead and the area has been de-stressed., Extensive rock-mass and support damage occurs in the extraction level at Premier Diamond mine, South Africa, as undercutting takes place: if abutment stress levels exceed 20% of the rock mass strength, movement along existing joints and minor shear failure and cracking in rigid concrete linings takes place; if induced stresses exceed 50% of the rock-mass strength, extensive failure of the rock in shear takes place along with destruction of shotcrete linings and concrete footwalls. Stress levels and consequent damage have been found, by monitoring, to be a function of: the extraction ratio on the undercut and extraction level prior to undercutting; the shape of the undercut face; the rate of undercut advance; and the distance of leads and lags between adjacent tunnels on the undercut level. Rigid shotcrete linings and concreted footwalls are only completed after the undercut has passed overhead and the area has been de-stressed.

Many of the issues facing the designers of a personnel evaluation system are common. The present paper describes recent Australian Army experience in the design and implementation of systems of evaluation for officers and soldiers. Two separate project teams developed the systems and their solutions are discussed in terms of their similarities and differences. Among the issues dealt with are the aims of evaluation, an open or closed system, forms of assessment, rating scales, reliability, validity and long term effectiveness. While the proposed systems contain much that is similar, there were significant differences in the approach taken by each project team. Comparisons are summarized in tabular form. Also included are copies of the appraisal documents and a selected bibliography. (Author)

At the Premier diamond mine in South Africa, a drilling level is established at the base of a block of ore to effect undercutting and caving; a second level, 15 m below, allows extraction of the caved ore. Induced stress levels and consequent damage are a function of the extraction ratio prior to undercutting, the shape of the undercut face, the rate of undercut advance, and the distance of leads and lags between adjacent tunnels on the undercut level. To ensure stability, all these parameters must be carefully planned and the mining sequence rigidly enforced. The minimum of development is completed on the extraction level prior to the undercut passing overhead; once the area has been destressed, development is completed rapidly. Support is installed in three phases: initial rock bolting; interim mesh, tendons and shotcrete; and rigid shotcrete linings installed after destressing., At the Premier diamond mine in South Africa, a drilling level is established at the base of a block of ore to effect undercutting and caving; a second level, 15 m below, allows extraction of the caved ore. Induced stress levels and consequent damage are a function of the extraction ratio prior to undercutting, the shape of the undercut face, the rate of undercut advance, and the distance of leads and lags between adjacent tunnels on the undercut level. To ensure stability, all these parameters must be carefully planned and the mining sequence rigidly enforced. The minimum of development is completed on the extraction level prior to the undercut passing overhead; once the area has been destressed, development is completed rapidly. Support is installed in three phases: initial rock bolting; interim mesh, tendons and shotcrete; and rigid shotcrete linings installed after destressing.

Premier mine uses mechanised panel retreat caving to extract ore from a kimberlite pipe which is intersected by a gabbro sill. Failure to exercise good draw control could cause ingress of gabbro waste, compaction of the kimberlite and loss of reserves. An underground vehicle monitoring and control system was introduced to assist in management of draw control. The data collected are used to determine the most effective drawpoint loading pattern. Each load can be related to its draw point of origin and the system has data on specific LHDs, tunnels, ore passes, dates, times and payloads. An interface is being developed between the vehicle monitoring and control system and a draw control linear programme that will optimise draw control and productivity., Premier mine uses mechanised panel retreat caving to extract ore from a kimberlite pipe which is intersected by a gabbro sill. Failure to exercise good draw control could cause ingress of gabbro waste, compaction of the kimberlite and loss of reserves. An underground vehicle monitoring and control system was introduced to assist in management of draw control. The data collected are used to determine the most effective drawpoint loading pattern. Each load can be related to its draw point of origin and the system has data on specific LHDs, tunnels, ore passes, dates, times and payloads. An interface is being developed between the vehicle monitoring and control system and a draw control linear programme that will optimise draw control and productivity.